We are currently recruiting for the position of Patient Transport Service ‘Ambulance Attendant’ in our expanding ambulance company, the role requires people of good solid dependability, preferably with a healthcare background, however not essential as full training will be provided, a full UK driving licence (preferably with C1 although not essential).

Previous Employment (most recent employer first). Please cover the last 10 years and state nature of business - if not public sector.

If you run out of boxes please ensure the attached CV is up to date.

Name of Present or Last Employer *

Address *

Address

Post Code *

Post Title

Contact Number *

Date of Appointment

Department Section

Brief Description of Duties *

Period of Notice

Last Day of Service*

Reason For Leaving *

Employment History 2

Name of Previous Employer*

Address *

Address

Post Code *

Post Title

Contact Number *

Date of Appointment

Department Section

Brief Description of Duties *

Period of Notice

Last Day of Service*

Reason For Leaving *

Employment History 3

Name of Previous Employer*

Address *

Address

Post Code *

Post Title

Contact Number *

Date of Appointment

Department Section

Brief Description of Duties *

Period of Notice

Last Day of Service*

Reason For Leaving *

Education

College Or University Qualifications

Course

Qualifications & Grades Obtained

School

Subjects

Qualifications & Grades Obtained

Professional Qualifications

Professional/Technical/Management Qualifications

Course Details

Are You a Member Of Any Professional / Technical Associations

YesNo

If Yes Please Give Details

Training & Development

Please give details of any training and development courses or non-qualifications courses which support your application. Include any on the job training as well as formal courses.

Title of Training Programme or Course

Duration of Course

Personal Statement

Please use this section to explain in detail how you meet the requirements of the employee profile. If you are or have been involved in voluntary/unpaid activites, please also includethis information. Attach any additional supporting documents at the bottom of this page.

*

Rehabilitation of Offenders Act (1974)

The post you are applying for, unless otherwise stated, is exempt from Section 4(2) of the Rehabilitation of Offenders Act 1974 by virtue of the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975. You are therefore, required to disclose here any convictions (including ‘spent’ convictions) for criminal offences brought against you and any pending court action.

Have you at ANY time been convicted of an offence, spent or unspent?*

YesNo

If Yes Please Give Details

Protecting Children & Vulnerable Adults

The following information may be required if the post you are applying for has a requirement for a Disclosure and Barring Service check.

Are you aware of any police enquires undertaken following allegations made against you, which may have a bearing on your suitability for this post?*

Yes No

Disability Discrimination Act

This Act protects people with disabilities from unlawful discrimination. We actively encourage applications from people with disabilities. The Disability Discrimination Act defines a disabled person as someone who has a physical or mental impairment which has a substantial and adverse long term effect on his or her ability to carry out normal day to day activities.

Do you have a disability which is relevant to your application?*

YesNo

If Yes Please Give Details

We will try to provide access, equipment or other practical support to ensure that people with disabilities can compete on equal terms with non-disabled people.

Do we need to make any specific arrangements in order for you to attend the interview?*

Yes No

If Yes Please Give Details

Health

Successful applicants will be required to complete a detailed medical questionnaire and may be required to attend a medical examination prior to being appointed.

Number of days sickness absence in the last 2 years:*

Please state number of occasions in the last 2 years:*

Referances

Please give the names and addresses of your two most recent employers (if applicable). If you are unable to do this, please clearly outline who your references are.

We are unable to provide work without referances

Referance 1

Name*

Position (job title)*

Work Relationship*

Organisation*

Address*

Address

Address

Post Code*

Phone Number*

Email

Any Comments

Are you willing for this referee to be approached prior to the interview*

Yes No

Referance 2

Name*

Position (job title)*

Work Relationship*

Organisation*

Address*

Address

Address

Post Code*

Phone Number*

Email

Any Comments

Are you willing for this referee to be approached prior to the interview*

Yes No

Referance 3

Name

Position (job title)

Work Relationship

Organisation

Address

Address

Address

Post Code

Phone Number

Email

Any Comments

Are you willing for this referee to be approached prior to the interview

Yes No

Declaration

A. Relatives/Other InterestsAny candidate who directly or indirectly canvasses a member of Cartello Ambulance Service Ltd Staff will be disqualified from consideration for the job. The Company does not bind itself to appoint any applicant.

Are you related to or do you have a close personal relationship with an Cartello Ambulance Service Ltd member of staff.*

Yes No

If yes, specify name(s), position(s) and relationship(s)

If appointed, do you have any interests or hold any appointments that may conflict with employment by the Company in the role for which you have applied?*